Surgical tool device

ABSTRACT

When processing bone tissue, the work site is often out of alignment with the insertion path of a tool device. A tool device ( 1 ) is provided with an endoscope ( 2 ), through the working channel ( 2.1 ) of which a guiding part ( 3 ) and a tool part ( 5 ) guided in this can be moved with their distal ends to a distal working area. The tool part ( 5 ) has a tool shaft ( 5.1 ) with a rotating tool ( 5.3 ). In the tool device there is a secure connection between the endoscope and the guiding part, during the task, and, this connection can be established in a simple manner prior to the beginning of the task and it can also be released again in a simple manner after the task ends. The guiding part ( 3 ) is able to be connected rigidly with the endoscope ( 2 ) axially.

CROSS REFERENCE TO RELATED APPLICATIONS

This application is a divisional patent application of United StatesNational Phase application Ser. No. 14/347,371 filed Mar. 26, 2014, ofInternational Application PCT/EP2013/001151 filed Apr. 18, 2013, andclaims the benefit of priority under 35 U.S.C. § 119 of DE 10 2012 008970.8 filed May 3, 2012, the entire contents of which are incorporatedherein by reference.

FIELD OF THE INVENTION

The present invention pertains to a surgical tool device, with anendoscope, through the working channel of which a guiding part and atool part being guided therein can be moved with the distal ends thereofto a distal working area, wherein the tool part has a tool shaft with arotary tool.

BACKGROUND OF THE INVENTION

Such surgical tool devices are used for working in tissue, especiallybone tissue, such as in the region of vertebrae, for example, in orderto remove tissue coming into contact with nerves there, alsointervertebral disk tissue, or to create conditions for stabilization,such as the fixation of two vertebrae. The tools to be used arerotationally driven tools, such as drills or cutters. They are insertedmicroinvasively endoscopically. It is often very difficult or impossibleto insert a tool device microinvasively endoscopically to its work sitesuch that it is aligned with the insertion path and also with the axisof the tool device, without jeopardizing delicate organs, blood vesselsor nerves over this path. It is therefore desirable or even necessary toselect a working channel at the end of which the work site will be outof alignment with or is offset in relation to the working channel andthe tool axis.

SUMMARY OF THE INVENTION

A basic object of the present invention is therefore to create asurgical tool device with a rotationally driven tool, which makes itpossible to process tissue, especially also bone tissue, outside thealignment of the axis of the tool or of the insertion path. Flexibilityshall now be ensured to the extent that the offset is possible not onlyin one direction, but with orientations over the entire circumference ofthe axis of the tool device.

This object is accomplished according to the present invention in asurgical tool device of this class by the guiding part being able toconnected axially with the endoscope.

The guiding part can therefore be connected rigidly with the endoscopeespecially in one working configuration, but it can also be releasedagain for insertion and removal. A circumferential groove is provided ina preferred embodiment at the proximal end of the endoscope and amovably mounted projection formed on the guiding part is provided formeshing with the circumferential groove. The projection is formed at thedistal end of a rocker-like catch and/or the projection and can bepressed into the circumferential groove under the action of a transitionpart of the guide cannula to fix the endoscope and deflector axiallywhen the circumferential groove of the endoscope and the projection ofthe guiding part are arranged in agreement with one another. On the onehand, a secure connection and, on the other hand, a connection that canbe easily established and also easily released, is created by thepresent invention between the endoscope and the working tool comprisingat least the guiding part and the tool part. It is thus ensured, inparticular, that when the tool head of the tool part is led distally outof the jacket area of the guiding part, which jacket area at firstsurrounds it fully, there is a secure connection between the endoscopeand the guiding part, which can be released, in a simple manner, onlywhen the tool head is retracted into the jacket of the guiding partsurrounding it.

Due to the variant of the tool device according to the present inventionwith a deflector, which has a laterally bent-off guiding surface in thedistal end area thereof and is formed with a rotationally driven toolpart, which is likewise designed flexibly in the distal end areathereof, directly proximally in front of the tool or tool head proper,the tool part is bent off to the side at the flexible end area thereofwhen being pushed in through the deflector and the tool head is thusbrought out of alignment with the axis of the deflector and tool part,so that the desired and intended task in a direction offset from theaxis or task out of alignment with the axis is possible as a result.

Provisions are made in a variant for the tool part to have a coildirectly proximally from the tool in its distal end area.

A guiding cannula, which receives the tool part and is mounted with thetool part within the guiding part, may be provided in a preferredembodiment.

If it is desired or necessary, as in the embodiment of the guiding partas a bent-off deflector, to bring the deflector, guiding part andguiding cannula of the tool part into a suitable rigid circumferentialalignment with one another, provisions are made in a preferredembodiment for the guiding cannula to have proximally an axiallyparallel outer groove and for the guiding part to have, within aproximal connection part, a pin directed axially parallel forcooperation with the groove, wherein especially a tube of the guidingpart is axially movable relative to its coupling part against the actionof a spring.

Provisions are made in further preferred embodiments of the presentinvention for the guiding cannula and the tool part to be connected withone another axially rigidly but rotatably relative to one another and/orfor the tool part to be able to be coupled with the driven shaft of arotating drive.

As was suggested above, provisions may be made, in particular, for theguiding part to be designed as a deflector with a guiding section bentoff laterally at its distal end in relation to its axis. Provisions arenow made in a variant for both the guiding cannula and the tool part tobe made flexible in their distal end area.

The guiding cannula is preferably provided in its distal end area withslots extending over only part of the circumference, with the slotsextending over 200° to 300°. The flexibility of the guiding cannula islikewise made possible here in the end area thereof in a simple manner.

Since the flexibility of the guiding cannula is not isotropic but can bepreferably bent in one direction in its end area in which the slots arelocated (or also in the opposite direction) especially in the embodimentof the above concrete embodiment, it is necessary to bring the deflectorand the guiding cannula [into] a rigid circumferential orientation inrelation to one another in the above-described manner, i.e., especiallysuch that the slots are arranged on the side of the cannula that islocated opposite the guiding surface of the deflector.

On the whole, the present invention creates a surgical tool device withwhich the surgeon can perform necessary tasks, especially cuttingresection tasks on bone material, such as vertebrae, or tissue resectionin the region of vertebrae in a simple and reliable manner.

Further advantages and features of the present invention appear from theclaims and from the following description, in which an exemplaryembodiment of the present invention is explained specifically withreference to the drawings. The various features of novelty whichcharacterize the invention are pointed out with particularity in theclaims annexed to and forming a part of this disclosure. For a betterunderstanding of the invention, its operating advantages and specificobjects attained by its uses, reference is made to the accompanyingdrawings and descriptive matter in which preferred embodiments of theinvention are illustrated.

BRIEF DESCRIPTION OF THE DRAWINGS

In the drawings:

FIG. 1 is a longitudinal sectional view through a preferred embodimentof the tool unit according to the present invention according to A-A inFIG. 2;

FIG. 2 is a top view of the device according to the present inventionaccording to FIG. 1 in the direction of arrow II;

FIG. 3 is a side view of a guiding part in the form of a deflector ofthe tool unit according to the present invention;

FIG. 4 is a longitudinal sectional view showing the deflector with theproximal connecting part;

FIG. 5 is an exploded view of the deflector according to FIGS. 3 and 4;

FIG. 6 is a juxtaposed view of a guiding cannula and a tool part withshaft and tool of the tool unit according to the present invention;

FIG. 7 is an enlarged partially cut away side view of the guidingcannula;

FIG. 8 is a longitudinal sectional view, through a tool unit accordingto the present invention, showing together with the view in FIG. 1, onepart of the sequence in which the tool according to the presentinvention is made ready for use;

FIG. 9 is a longitudinal sectional view, through a tool unit accordingto the present invention, showing together with the view in FIG. 1,another part of the sequence in which the tool according to the presentinvention is made ready for use;

FIG. 10 is a longitudinal sectional view, through a tool unit accordingto the present invention, showing together with the view in FIG. 1,another part of the sequence in which the tool according to the presentinvention is made ready for use; and

FIG. 11 is a longitudinal sectional view, through a tool unit accordingto the present invention, showing together with the view in FIG. 1,another part of the sequence in which the tool according to the presentinvention is made ready for use.

DESCRIPTION OF THE PREFERRED EMBODIMENTS

Referring to the drawings in particular, in the embodiment shown, thesurgical tool device 1 according to the present invention has anendoscope 2, a guiding part 3 in the form of a deflector 3, a guidingcannula 4 and a tool part 5.

The endoscope 2 has a stretched working channel 2.1 with a proximalopening 2.2 aligned therewith for inserting tools. The endoscope 2 has,furthermore, not shown here more specifically, a bent illuminating inlet2.3 and an observation outlet 2.4 extending in parallel hereto, whichare in connection with corresponding channels transparent to light,wherein an illuminating unit may be connected to the former and anobservation unit, for example, a camera, can be connected to the latter,and a screen can be connected via these. Finally, rinsing inlets andrinsing outlets 2.5, 2.6 are provided, at least one of which andoptionally also both may be directly in connection with the workingchannel during intermittent rinsing and suction. An endoscope usuallyhas, besides the working channel, as was already suggested, furtherchannels, for example, for optical transmission and/or for rinsing,which are not shown specifically in the figures for clarity's sake,because these are not specifically relevant to the subject of thepresent invention.

A deflector tube 3.1 of the guiding part 3 is arranged in the workingchannel 2.1 of the endoscope 2. The deflector tube 3.1 has a distalopening 3.2. Extending beyond this, it has a one-sided guiding section3.3, which is slightly bent in relation to the axis X of the deflectortube 3.1 or of the guiding part 3.3 with an essentially axial extension,which reaches from a wall side of the deflector tube 3.1 laterally in anarc-shaped pattern to a radial position, which is approximately alignedwith the side of the deflector tube 3.1 located diagonally opposite theoutlet side of the guiding section 3.3. Section 3.3 has a spoon-shapeddesign.

A connecting part 3.5 of the guiding tube 3 has a cylindrical jacket3.6, which acts as a catch holder for a rocker-like catch 3.7, by meansof which the deflector 3 can be securely fixed to the endoscope 2. Abushing 3.8 is fixed at the distal end of the cylindrical jacket 3.6 inthe interior thereof, for example, by bonding, welding or screwing in;it may also be made in one piece with the jacket 3.6.

The deflector tube 3.1 is passed slidingly through the bushing 3.8 andis rigidly connected, on the one hand, with a ring washer 3.9. On itsside facing away from the deflector tube 3.1, the ring washer 3.9 has,furthermore, a pin 3.10, which extends radially offset but in parallelto the axis X and whose function will be explained below.

A coil spring 3.11 is arranged between the bushing 3.8 and the ringwasher 3.9, and a (plain) washer each, made of metal, preferablystainless steel, which material may also be that of the spring 3.11, isarranged between the spring 3.11 and the respective bushing 3.8 as wellas the ring washer 3.9.

The deflector tube 3.1 can be correspondingly displaced against theaction of the spring 3.11 in the distal direction and is displaced bythe spring to a limited extent in the proximal direction upon release.

The guiding cannula 4 has, on the one hand, a metallic shaft 4.1 and, onthe other hand, a transition part 4.2 (FIG. 6), which can be recognizedmore clearly in FIG. 7, at its proximal end.

The distal end area of the shaft 4.1 is provided on one side with aplurality of slots 4.3, which are located in parallel radial planes andextend over more than half the circumference of the shaft, i.e., overabout 200° to 270°. The end area of the shaft 4.1 can be bent as aresult towards the side of the slots (FIGS. 9 and 10).

Since bending in the direction predetermined by the course of the bent,spoon-shaped end area of the deflector 3 must be guaranteed, it must beensured that the guiding cannula 4 is seated in the correct orientationin the deflector tube 3.1.

This purpose is served, on the one hand, by the above-mentioned pin 3.10of the deflector 3 and, on the other hand, by an axially parallellongitudinal groove 4.4, which is formed on the transition part 4.2 ofthe guiding tube 4, and with which the pin 3.10 meshes when the shaft4.1 is pushed into the deflector tube 3.1 and the transition part 4.2 ispushed into the jacket 3.6 of the guiding part 3, so that the guidingcannula 4 can only be pushed into the deflector 3 in the angularorientation determined hereby.

Further, FIG. 6 shows the tool part 5 with an essentially rigid toolshaft 5.1, with a proximal coupling part 5.2 and with a tool 5.3, as acutting head, but other tools to be used in a rotational manner may beused as well.

The tool shaft 5.1 is likewise made flexible in its distal end area,namely, due to a coil 5.4, which is only suggested in the drawing,especially in the form of a coil spring, in which the individual turnsare directly in contact with one another.

To use the tool unit according to the present invention, the tool part 5with the tool shaft 5.1 is pushed into the guiding tube 4, as it isshown, for example, in FIG. 1, and the tool 5.3 proper projects distallyover the distal end of the shaft 4.1 of the guiding tube 4, i.e., itprotrudes from the shaft 4.1. The tool part 5 and the guiding tube 4 areconnected with one another axially, but in such a way that they rotatein unison, optionally directly via a radial pin (not shown), which isfixed via a transition part 4.2 protruding into an annular groove at thedistal end of the coupling part 5.2. The tool part 5 and the guidingtube 4 are coupled with one another in this position axially rigidly butrotatably relative to one another in the proximal area of the parts 4.2,5.2. The coupling may also be brought about, in particular, via ahandle, which has a rotary drive and is connected axially—and rotatingin unison—with the connecting part 4.2 of the guiding tube 4 by means ofa locking connection in a manner that is not shown, while the coupling5.2 of the tool part 5 is also connected axially with the tool shaft ofthe drive in the handle via the connection of the connecting part 4.2with the handle in such a way that they rotate in unison.

To connect the endoscope 2 and the deflector tube 3.1, the latter is atfirst pushed into the endoscope 2 to the extent that the projection 3.13of the catch 3.7 reaches at the deflector 3 an axial position thatagrees with that of the circumferential groove 2.7 on a contact part 2 aof the endoscope. A proximal projection 3.7 a of the catch 3.7 isbroader than the groove 4.4, so that as soon as the catch 3.7 is pushedwith its proximal projection 3.7 a over the transition part 4.2, theproximal projection 3.7 a of the catch 3.7 is raised radially or pressedoutwardly by the circumferential surface of the transition part 4.2 andthe distal projection 3.13 of the catch 3.7 is thus pressed into thegroove 2.7 on the grip part 2.5 of the endoscope 2 (transition from FIG.8 to FIG. 9), so that the two are thus coupled rigidly axially (FIG. 9).

The tool unit according to the present invention is preferably used toprocess, such as cut out bone material on vertebrae of the spine. Afterthe minimally invasive preparation of an insertion path and insertion ofthe endoscope to the work area at the corresponding bone, especiallyvertebra, the deflector 3 is pushed in at first with the deflector tube3.1 with the guiding tube 4 pushed in completely, but without tensioningthe spring 3.11, for example, starting from the relative positions shownin FIG. 1 to the relative positions of the parts as shown in FIG. 8.

The guiding tube 4 is then advanced until the transition part 4.2 comesin contact with the ring washer 3.9, likewise still without tensioningthe spring 3.11, as this is shown in FIG. 9. The deflector tube 3.1 nowremains up to its distal opening 2.2 within the endoscope 2.

By contrast, both the guiding tube 4 with the flexible end area providedwith the slots 4.3 and the tool part 5 with its end area, which isflexible due to the coil 5.4, project. Both flexible end areas will cometo lie in the spoon-like guiding section 3.3 of the deflector 3 and arebent to the side by the deflector and with it the tool 5.3 as well,which also projects distally over the tip 3.4 of the spoon-like guidingsection 3.3 of the deflector 3. As a result, the tool 5.3 can operatefreely and prepare, for example, a flute in the bone material of avertebral after the rotary drive is switched on.

An axial feed and thus an axial roughing of the tool is brought about bymoving the tool part 5 with the guiding tube 4 against the spring actionrelative to the endoscope 2 while compressing the spring 3.11 in thedistal direction via the handle of the drive (transition from FIG. 9 toFIG. 10), while the deflector 3.1 is also carried via the ring washer3.9.

After the end of the task, the guiding part 3 designed as a deflector isagain released from the endoscope 2 at the transition from FIG. 9 toFIG. 8 by the transition part 4.2 of the guiding cannula releasing againthe proximal projection 3.7 a of the catch 3.7 when said guiding cannulais pulled out, so that the distal projection 3.13 can again be releasedfrom the circumferential groove 2.7 of the endoscope 2 and the endoscope2 and the guiding part 3 (deflector) can thus be separated.

Individual embodiments or individual features shown in the abovedescription and also in the drawings may be essential for the embodimentof the present invention not only in connection with other individualembodiments, but also in themselves without a necessary connection withother individual features or individual embodiments described in theirlinguistic context.

While specific embodiments of the invention have been shown anddescribed in detail to illustrate the application of the principles ofthe invention, it will be understood that the invention may be embodiedotherwise without departing from such principles.

What is claimed is:
 1. A surgical tool device comprising: a guidingpart; a tool part; an endoscope with a working channel through which theguiding part and the tool part, guided in the same, are moveable withdistal ends thereof to a distal working area, wherein the tool part hasa tool shaft with a rotary tool, and the guiding part is rigidlyconnectable with the endoscope axially, whereby when connected, there isno relative movement in an axial direction; and a guiding cannula thatreceives the tool part and is receivable with the tool part, within theguiding part and wherein the guiding part comprises a deflector with aguiding section bent to a side in relation to a deflector axis at adeflector distal end and wherein both the guiding cannula has a flexibledistal end area and the tool part has a flexible distal end area,wherein the guiding cannula has an axially parallel outer grooveproximally and the guiding part has a pin directly axially parallelwithin a proximal connecting part for cooperating with the groove.
 2. Adevice in accordance with claim 1, wherein the endoscope has acircumferential groove at the proximal end of the endoscope and theguiding part has a movably mounted projection formed on the guiding partfor meshing with the circumferential groove.
 3. A device in accordancewith claim 2, wherein the projection is formed at the distal end of arocker catch.
 4. A device in accordance with claim 3, wherein in case ofan axially agreeing arrangement of the circumferential groove of theendoscope and of the projection of the guiding part, the projection ispressable into the circumferential groove under the action of atransition part of the guiding cannula for fixing the endoscope and thedeflector axially.
 5. A device in accordance with claim 1, wherein theguiding cannula and the tool part are connected to one another axiallyrigidly but rotatably relative to one another.
 6. A device in accordancewith claim 2, wherein the guiding cannula and the tool part areconnected to one another axially rigidly but rotatably relative to oneanother.
 7. A device in accordance with claim 1, wherein the guidingpart and the guiding cannula are connectable with one another in such away that they rotate in unison.
 8. A device in accordance with claim 2,wherein the guiding part and the guiding cannula are connectable withone another in such a way that they rotate in unison.
 9. A device inaccordance with claim 1, further comprising a spring wherein the toolpart has a coupling part and the guiding part has a tube that is axiallymovable relative to the coupling part against an action of the spring.10. A device in accordance with claim 2, further comprising a springwherein the tool part has a coupling part and the guiding part has atube that is axially movable relative to the coupling part against anaction of the spring.
 11. A device in accordance with claim 1, whereinthe tool part is coupleable with the driven shaft of a rotating drive.12. A device in accordance with claim 2, wherein the tool part iscoupleable with the driven shaft of a rotating drive.
 13. A surgicaltool device comprising: an endoscope with a working channel; a guidingpart received in the working channel, the guiding part being moveable inthe working channel to move a distal end to a distal working area, theguiding part including a connecting part for connecting anddisconnecting the guiding part from the endoscope to releaseably fix theguiding part in an axial position with respect to the working channel;and a tool part guided in the guiding part, wherein the tool part has atool shaft with a rotary tool further comprising a guiding cannula,which receives the tool part and which is receivable, with the toolpart, within the guiding part and wherein the guiding part comprises adeflector with a guiding section bent to a side in relation to adeflector axis at a deflector distal end and wherein both the guidingcannula has a flexible distal end area and the tool part has a flexibledistal end area, wherein the guiding cannula has an axially parallelouter groove proximally and the guiding part has a pin directly axiallyparallel within a proximal connecting part for cooperating with thegroove.
 14. A device in accordance with claim 13, wherein the endoscopehas a circumferential groove at a proximal end of the endoscope and theguiding part comprises a movably mounted projection formed on theguiding part for engaging with the circumferential groove.
 15. A devicein accordance with claim 14, wherein in case of an axially agreeingarrangement of the circumferential groove of the endoscope and of theprojection of the guiding part, the projection is pressable into thecircumferential groove under the action of a transition part of theguiding cannula for fixing the endoscope and the deflector axially. 16.A device in accordance with claim 13, wherein the guiding cannula andthe tool part are connected to one another axially rigidly but rotatablyrelative to one another.
 17. A device in accordance with claim 14,wherein the guiding cannula and the tool part are connected to oneanother axially rigidly but rotatably relative to one another.
 18. Adevice in accordance with claim 13, wherein the guiding part and theguiding cannula are connectable with one another in such a way that theyrotate in unison.
 19. A device in accordance with claim 14, wherein theguiding part and the guiding cannula are connectable with one another insuch a way that they rotate in unison.
 20. A device in accordance withclaim 13, further comprising a spring wherein the tool part has acoupling part and the guiding part has a tube that is axially movablerelative to the coupling part against the action of the spring.
 21. Adevice in accordance with claim 14, further comprising a spring whereinthe tool part has a coupling part and the guiding part has a tube thatis axially movable relative to the coupling part against the action ofthe spring.